Application of Multiprotocol Medical Imaging Communications and an Extended DICOM WADO Service in a Teleradiology Architecture

Multiprotocol medical imaging communication through the Internet is more flexible than the tight DICOM transfers. This paper introduces a modular multiprotocol teleradiology architecture that integrates DICOM and common Internet services (based on web, FTP, and E-mail) into a unique operational domain. The extended WADO service (a web extension of DICOM) and the other proposed services allow access to all levels of the DICOM information hierarchy as opposed to solely Object level. A lightweight client site is considered adequate, because the server site of the architecture provides clients with service interfaces through the web as well as invulnerable space for temporary storage, called as User Domains, so that users fulfill their applications' tasks. The proposed teleradiology architecture is pilot implemented using mainly Java-based technologies and is evaluated by engineers in collaboration with doctors. The new architecture ensures flexibility in access, user mobility, and enhanced data security. 1. Introduction Digital Imaging and Communication in Medicine (DICOM) network protocols are widely used for reviewing images and performing primary diagnosis within radiology and other imaging departments, by means of Picture Archiving and Communication System (PACS). DICOM, which is the communication standard for medical imaging, is also applied in teleradiology cases, where the transfer of patient radiological images from one location to another for the purposes of interpretation and/or consultation is performed. In teleradiology, professionals belonging to different departments of the hospital (internal professionals) or professionals at home (external professionals) communicate with the radiology department. In these cases [1], DICOM network protocols are less frequently used to share DICOM Objects for diagnostic purposes, especially between hospital departments and external professionals. Image communication is not performed strictly for diagnosis only but also for educational, scientific, and other co-operational activities of external professionals. In these activities, they have lower expectations of image quality and reliability [1]. They desire more flexible applications, which can be integrated with their other desktop applications and less centralized system setup and configuration. This paper focuses on teleradiology performed by external professionals through the Internet. DICOM Supplement 54 (DICOM-E-mail) [1] suggests a connection between the Internet and hospital medical communication. In [2], an example of DICOM protocols’ vendor-specific